Leukemia and Hodgkin's Disease A LTHOUGH WE CAN NOW look back upon 131

-£* • years of contemplation, speculation, and experimentation since Hodgkin's (1) first de-scription of the disease that now bears his name, our knowledge of the true nature of the disease has not been increased materially. The following questions that Dameshek (2) asked in 1933 regarding Hodgkin's disease are pertinent today because they still remain un-answered: "Is it infectious or malignant in nature? " (Of course, with the revival of the virus theory in the etiology of cancer, it may be both infectious and malignant in nature.) "Is the type cell of lymphoid or reticuloendothelial origin? " "Is it a local disease of peripheral lymph nodes or is it a generalized disorder of the hematopoietic or reticuloendothelial sys-tems?" In 1902, Dorothy Reed (3) stated, "We should limit the term Hodgkin's disease to designate a clinical and pathological entity, the main fea-tures of which are painless progressive glandu-lar enlargements usually starting in the cervical region, without the blood changes of leu-kemia. " Since that time, the trend has been to include Hodgkin's disease with lympho-sarcoma, reticulum-cell sarcoma, and giant fol-licle lymphoblastoma as one of the "malignant lymphomas. " Because of the definite propensity of the solid lymphosarcomas to enter a "fluid" phase which we recognize as leukemia, it has naturally been accepted that cases of Hodgkin's disease could also undergo such a transition. The concept of linking "malignant lymph-omas " together, including the possibility of their transition to leukemia, implies a com-mon genesis for these disorders for which there is no justifiable foundation